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A few weeks ago, late in the evening, 15-year-old Rohit doused himself in kerosene. He had been suffering from depression for a while. His parents were in the process of splitting and his grades in school had fallen. In desperation, his mother called Saifi Hospital. The hospitalâ€™s ambulance, dedicated to cases of mental breakdown or trauma, sped to their home in Worli. A junior psychiatrist, a counsellor and a ward boy managed to sedate Rohit and take him to hospital. He is still in hospital, but could have suffered a fate far worse. He was but a matchstick away from death. Shilpa, 24, could not cope with the fact that her widowed mother wanted to remarry. In a rage, she threatened to burn her mother and burn down their house. Her mother called the Saifi ambulance. Shilpa was sedated and this helped tide over the crisis.
At any given time, one per cent of the population suffers from a serious mental disorder and anywhere between 5 to 10 per cent suffer from minor mental problems. But the state heath infrastructure in Mumbai, a city which breeds stress like mosquitoes, is woefully inadequate to handle the problem. The three civic hospitals have 11 trained psychiatrists between them; there are nine trained psychiatrists in eight other peripheral Mumbai hospitals, and private psychiatrists number 250. Mumbai has over 15 million people, and every family faces crisis situations at some time or another. Some families are rich enough to go to a private counsellor whose fees go up to as much as Rs 1000 per session. But not everyone has this kind of money. More often than not, helpless families have no clue about what to do and whom to turn to when plates are smashed and a son or daughter suddenly grabs a knife and spirals out of control. And if the episode happens in the late evening or at night, it is nothing short of a nightmare. Frantic calls are made to the family doctor, who despite having the advantage of knowing his patientâ€™s problems, is not the right person to deal with situations of violence or suicide.
Another crucial support system that unhooks in the night is the helplineâ€”that distant but intimate ear into which the city pours its stories of rejection, abuse and failure. Most of Mumbaiâ€™s helplines call it a day at around 10 pm. Pravin Mahendra of the Samaritan helpline says that a dedicated mental health helpline run by the state could be of enormous help. There have been cases when callers have slit their wrists, panicked, and then dialled the helpline; the volunteer at the other end then calmly tells the caller that it is not too late, and asks if he can inform the hospital or police. Lives have been saved by this crucial intervention, which by night is rarely available.
Akila Maheshwari, convener of NAMI India, an NGO working in mental health care, says that while Mumbai does have an emergency mental health care system, it is insufficient. She points our that there is just a single dedicated mental health care ambulance run by Saifi. At a basic of Rs 1000 per visit, the ambulance does not come cheap, and if the patient lives on the outskirts, in Mira Road or Navi Mumbai, costs mount.
But Dr Y M Matcheswalla, assistant professor (psychiatry department) at the JJ hospital, says that with growing awareness things are improving. â€œAround 20 to 25 hospitals in the private and public sector have dedicated psychiatry personnel available even at odd hours. In Mumbai, if a person cannot afford treatment at a private hospital, he or she can always go to JJ or GT hospital. The best way to tackle a mental health crisis or a breakdown in the night is by approaching the casualty department of these hospitals,â€ he says.
Mental health professionals advise that if a family member has a violent episode or threatens bodily harm to himself or another family member, the first thing to do is summon an ambulance or even the police if no medical help is at hand. Calling the cops may sound bizarre, but there have been cases where on police intervention, the patient has been sedated and the situation brought under control. TNN

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